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Vision & Eyewear Benefit

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Preserving your best vision is key to taking good care of your overall health.

In addition to the vision-related benefits covered by Original Medicare, your Martin’s Point Generations Advantage plan offers extra benefits that go beyond Original Medicare.



Understanding Your Coverage

Your vision and eyewear benefits fall under two separate coverage categories:
Original Medicare (Part B) Coverage

You receive vision and eyewear benefits covered under Medicare Part B:

  • Medicare-Covered Eye Exam: Copay varies by plan for outpatient physician services for the diagnosis and treatment of diseases and injuries of the eye, including treatment for age-related macular degeneration.
  • Medicare-Covered Post-Cataract Surgery Eyewear: You pay 20% of the Medicare-allowable rate for one pair of standard eyeglasses or contact lenses after each cataract surgery that includes insertion of an intraocular lens. Learn More
Generations Advantage Benefit Coverage

Your plan comes with extra vision and eyewear benefits:

  • $0-Copay Annual Routine Vision Exam: You pay a $0 copay for one routine vision exam per year. This benefit includes a diabetic (dilated-pupil) eye exam for people with diabetes and glaucoma screening for those at high-risk. See your Evidence of Coverage for details.
  • Eyewear Allowance: You receive an annual amount for prescription lenses, frames, and/or contact lenses for the purpose of correcting/improving your vision. Availability and amount varies by plan (see below).
  • EyeMed Eyewear Discount: Available as an extra benefit through your Northeast Delta Dental plan. Learn More

Eyewear annual allowance by plan

Below are the specific vision and eyewear benefit maximum for each Generations Advantage plan.

2027 Prime (HMO) Plan

Martin's Point star icon All Prime Plans
Androscoggin, Aroostook, Cumberland, Franklin, Kennebec, Knox, Lincoln, Oxford, Penobscot, Sagadahoc, Waldo, York

Eyewear

  • Eyewear Allowance: $150 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $45 copay
2026 Prime (HMO-POS) Plan

Martin's Point star icon All Prime Plans
All Maine counties

Eyewear

  • Eyewear Allowance: $150 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $40 copay
2027 Select (PPO) Plan

Martin's Point star icon Plan ID: H1365-006
Aroostook, Franklin, Knox, Lincoln, Oxford, Penobscot, Waldo

Eyewear

  • Eyewear Allowance: $100 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance—in-network | 50% coinsurance—out-of-network
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $50 copay—in-network | 50% coinsurance—out-of-network


Martin's Point star icon Plan ID: H1365-007
Androscoggin, Cumberland, Kennebec, Sagadahoc, York

Eyewear

  • Eyewear Allowance: $150 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance—in-network | 50% coinsurance—out-of-network
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $45 copay—in-network | 50% coinsurance—out-of-network

2026 Select (LPPO) Plan

Martin's Point star icon Plan ID: H1365-001
Androscoggin, Cumberland, Kennebec, Sagadahoc, York

Eyewear

  • Eyewear Allowance: $150 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance—in-network | 30% coinsurance—out-of-network
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $25 copay—in-network | 50% coinsurance—out-of-network


Martin's Point star icon Plan ID: H1365-005
Aroostook, Franklin, Hancock, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Somerset, Waldo, Washington

Eyewear

  • Eyewear Allowance: $100 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance—in-network | 30% coinsurance—out-of-network
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $40 copay—in-network | 50% coinsurance—out-of-network

2027 Essential (HMO) Plan

Martin's Point star icon Plan ID: H5591-018 & H5591-019
Aroostook, Androscoggin, Cumberland, Franklin, Kennebec, Knox, Lincoln, Oxford, Penobscot, Sagadahoc, Waldo, York

Eyewear

  • Eyewear Allowance: $100 per year
  • EyeMed Discount Program (available for those enrolled in Dental Plus plan only): Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $55 copay


Martin's Point star icon Plan ID: H5591-020
Hancock, Piscataquis, Somerset, Washington

Eyewear

  • Eyewear Allowance: Not covered
  • EyeMed Discount Program (available for those enrolled in Dental Plus plan only): Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $55 copay

2026 Essential (HMO-POS) Plan

Martin's Point star icon All Essential Plans
All Maine counties

Eyewear

  • Eyewear Allowance: $100 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $55 copay
2027 Alliance (HMO) Plan

Martin's Point star icon Plan ID: H5591-003
All Maine counties

Eyewear

  • Eyewear Allowance: $200 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $0 copay
2026 Alliance (HMO) Plan

Martin's Point star icon Plan ID: H5591-003
All Maine counties

Eyewear

  • Eyewear Allowance: $200 per year
  • EyeMed Discount Program: Up to 35% savings on eyewear purchases—Learn More
  • Part B Eyewear: 20% coinsurance
    For cataract-related eyewear—Learn More

Vision Care

  • Annual Routine Eye Exam: $0 copay
  • Non-Routine Part B Eye Exam: $0 copay
Martin's Point star iconEyewear Benefit | List of Qualifying Items & Services

Below you will find a complete list of items and services that are covered by your supplemental Eyewear benefit:

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Using Your Benefits

Purchasing your eyewear

To make eligible purchases under your vision/eyewear benefit, take the following steps:

Review your plan information.

Find your plan's benefit amount and coverage information on this page or in your Evidence of Coverage documents.

Purchase your eligible items.

Use your own funds and submit for reimbursement online or by mail. Learn More

Save your receipt and proof of purchase.

Save your itemized receipt and proof of payment to include with any reimbursement requests or in case we need to verify a purchase.

Using the EyeMed discount program

In addition to your eyewear allowance, you can get discounts on frames, lenses, and contact lenses by using the the discount program offered through EyeMed. Please note that eye exams are not available through this program. 

2027 EyeMed Discount Flyer [PDF]

Note: The reimbursement benefit does not apply to purchases made through the EyeMed Discount Program. 

Access your discount savings.

To use your EyeMed discount, visit EyeMed Vision Care or call 866-246-9041.

When prompted, simply say "Benefits" and specify whether you are looking for glasses or contacts. Follow the prompts to state the type of lenses you need.

Find your local retailer.

Choose from an extensive network of retailers for your eyewear. Provide your EyeMed Group Number 9231093 at the time of purchase.

For more information about the EyeMed discount program, please see the EyeMed Vision Care FAQs.

If you need additional guidance, please call 1-866-246-9041 or visit their website.

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How to Get Reimbursed

Submit for reimbursement online or by mail

Submit your reimbursement requests online or by mail using the forms below.  

Please Note: Reimbursement requests must be received by the plan no later than 120 days following date of purchases.

Online Reimbursement

To submit a reimbursement request online, visit:

Online Reimbursement

For prompt processing of your online reimbursements, set up your direct deposit today—a one-time step that simplifies all future transactions. Use the Direct Deposit Guide [PDF] to get started.

Mail-In Reimbursement

To submit for reimbursement via mail, use the following form:


Mail completed forms to:

Martin's Point Generations Advantage Claims Department
PO Box 3003
Fargo, ND 58108

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Frequently Asked Questions

The proof of payment must indicate what was bought, how much it cost, and how it was paid for.

This can be in the form of an itemized register receipt, stamped bill, or paid statement. Cancelled checks, credit card bills, and bank statements can also be used, but they must show detail relating to the item purchased.

We do not accept invoices, order / pick up confirmations, or shipping statements with no proof of payment. It is okay for you to use a gift card or gift certificate as the payment method, as long as the receipt indicates the payment method.

Yes! You are eligible to receive up to the entire eyewear allowance amount that is offered under your Generations Advantage plan even if you join the plan mid-year. As a reminder, dates for received services or purchased items must be within the current plan year and within your dates of coverage in order to be reimbursed under that year's benefit.

If you place an order for an item, but payment is not taken until a later date, the date you placed the order is considered the date of purchase as long as your receipt shows the date you placed the order. For example, if you place an order for an item on 12/31 but payment is not taken from your account until 1/1, your purchase date would be considered 12/31 provided that your receipt lists the 12/31 order date.

A member can use credit card points or a gift card to purchase an item as long as the receipt shows the cash value of the item.

Members receive their notification of eyewear reimbursement determination on their Explanation of Benefits documents within 30 days after the reimbursement claim is processed. Denial reasons will be listed on the Explanation of Benefits.

Here are some tips to ensure the smoothest reimbursement experience:

  • Make sure your purchase is on the list of items/services eligible for reimbursement.


For mailed-in requests:

  • Use the PDF form only and complete all sections.
  • Mail the form and copy of receipt/proof of payment to:

Martin's Point Generations Advantage
Claims Department
P.O. Box 3003
Fargo, ND 58108


For mailed-in and online requests:

  • Itemized receipts and proof of payment documents (copies only) must be enclosed with mailed requests or uploaded with online requests. They must show what was purchased, how much it cost, how you paid for it, and the date it was purchased.

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Need help? We're here for you.

Whether you’re exploring plan options or already a Generations Advantage member, our team is ready to help.

Prospective Members: Call us at 1-844-300-0160 (TTY: 711)
Current Members: Call Member Services at 1-866-544-7504 (TTY: 711)